In the wake of the most destructive tornado outbreak of the year, Direct Relief’s Emergency Response Team has offered medical assistance to its nonprofit health center partners across the U.S. located near areas affected by Sunday’s deadly string of storms.

At least 18 people are reported dead, hundreds more are injured, and thousands are still without power following 31 recorded tornadoes that touched down across the Midwest and South, reports NBC News. Arkansas was the hardest hit state with 16 recorded deaths.

On Friday, 424 health center partners in 17 at-risk states were contacted in advance of the storms (pictured above). Direct Relief is now reaching out to partners in the most affected areas to assess medical needs.

Direct Relief has readied inventory in its warehouse, including family emergency kits, that are on hand and ready to ship to people affected by the storms.

The Emergency Team remains on alert as tornado watches continue through the beginning of the week. An update was sent to 529 partners in 18 states.

As clean up efforts begin, Direct Relief will stand ready to respond to any requests for assistance that may arise. Clean up and rescue activities can cause as many injuries as the storm itself. Falling objects and sharp debris, like nails, can cause acute wounds and put people at risk of contracting bacterial diseases, such as tetanus. Damaged power lines, gas lines, or electrical systems can increase risk of fire, electrocution, or an explosion.

Follow @DirectRelief on Twitter for the latest news from partners as it unfolds.